Treatment for Periodontal Disease
The treatment for periodontal disease varies on a patient-by-patient basis. The methods used depend on a variety of factors such as the type and how severely the disease has progressed. When you seek treatment your dentist and dental hygienist will recommend the most appropriate treatment for your condition.
The progression of periodontal disease is the result of bacteria, plaque, or tartar building up in the space between the tooth and gums. This results in irritation of surrounding tissue in the mouth, which can cause severe damage to the gums and ultimately the bone that supports the teeth.
It is essential that gingivitis be caught in the early stages; early detection will minimize any damage that may occur. Two regular cleaning appointments are recommended.
More advanced stages of the disease require a more intensive cleaning treatment, called scaling and root planing. A numbing solution is used on the area, as the procedure requires the removal of hard to reach tartar, plaque, and toxins both above and below the gum. Rough spots on the teeth that are susceptible to bacteria build up are often smoothed to prevent a reoccurrence on the disease in that area. After the procedure, medications, special medicated mouth rinses, and an electric toothbrush may be recommended by you dentist to help control infection and aid in the healing process.
Periodontal surgery may be required if the pockets do not heal properly after the procedure. Surgery will help reduce the depth of the pockets and make the teeth easier to clean. Seeing a periodonist may be recommended, as they are dentists who specialize in the care of the gums and supporting teeth bones.
Aside from scaling and root planning, here are some other common treatments for periodontal disease:
- Tissue regeneration – Regrowth of bone and gum tissues can be encouraged by a grafting procedure, in which a membrane is inserted in affected areas to assist the biological tissue in the regeneration process.
- Pocket elimination surgery – To reduce the size of the sulcus, the space between the tooth and gum, your dentist may recommend pocket elimination surgery (also known as flap surgery). This surgery requires the dentist to clean the affected area of disease-causing bacteria before securing the gum tissue in place. This procedure allows the tissue to more easily reattach itself.
- Dental implants – Tooth loss is a serious possibility with periodontal disease. Luckily, teeth can be replaced with dental implants. These are prosthetic teeth that can be implanted in the gum once the tissue has healed properly.
Periodontal Disease Diagnosis
Your dentist or dental hygienist can diagnose periodontal disease during what is known as a periodontal examination. This is generally done during regular check-ups and dental cleanings.
A dental instrument called a periodontal probe is is used to examine the inflamed or infected tissue an measure the sulcus (space) between the tooth and gum. A normal, healthy sulcus generally has a depth of approximately three millimeters or less. The periodontal probe helps specify if the sulcus is larger than the average. The most extensive the disease is, generally the larger the space between the teeth and gums.
The pocket depths, amount of bleeding, irritation, and tooth movement will all play a role in how your dentist or dental hygienist diagnose you into the following categories:
This is first stage of the disease and the easiest to treat. Plaque and other bacteria may irate your gums causing tenderness and possible bleeding.
During this stage plaque has hardened into tartar making it more difficult to treat. As the build up of these irritants continue the gums will begin to regress from the teeth. As a deeper sulcus forms the space becomes filled with even more bacteria. The gums will become very irritated, inflamed, and bleed easily. At this stage, bone loss is possibility.
At this stage the teeth will lose the remaining support from both the gum and bone surrounding the teeth. The periodontal ligament may even be damaged in the process. Unless this disease is treated immediately teeth may become very lose and tooth loss will be a real possibility.
What is Periodontal (Gum) Disease?
Periodontal disease is a condition in which surrounding and supporting tissues of the teeth become inflamed causing the gum to recede from the tooth. As it continues a patient many notice loose teeth and bleeding or inflamed gums. Late stages of the disease also affect the support the tooth has from the underlying jawbone.
Gingivitis is often a prelude to periodontal disease and is caused by a bacterial infection of surrounding gum tissue. The bacteria in plaque can start to irritate the gums supporting the teeth. One the infection becomes prevalent it becomes increasingly harder to remove and treat. The progressive nature of periodontal disease can lead to irreversible damage to the tooth, surrounding tissue, and the supporting bone.
Periodontal Disease and Diabetes
Research has shown that there is a high correlation between periodontal disease and diabetes. It is often unrecognized that periodontal disease is a common complication of having diabetes, particularly when diabetes is left uncontrolled or untreated.
Periodontal disease, a progressive gum and tooth disease that can lead to tooth loss, is common among this population. The disease begins with the build up of bacteria and plaque around teeth and gums that colonize in the space between the tooth and gum creating a larger space that can cause the surrounding tissue to be destroyed or inflamed.
Diabetes is characterized by too much glucose (or sugar) in the blood. Type II diabetes is marked by the inability to regulate insulin levels meaning that an excess of glucose may remain in the blood. Type I diabetics do not produce insulin causing a similar reaction.
Here are ways in which diabetes and periodontal disease are linked:
- Increased blood sugar – Higher sugar levels in the mouth give something for the bacteria to feed off of and grow. For this reason it is essential that people with diabetes maintain excellent oral hygiene.
- Blood vessel thickening – Thick blood vessels mean that blood to tissue exchanges are more difficult. This can result in harmful waste and bacteria being left in the mouth, giving way to the disease.
- Smoking – Tobacco does an extreme amount of damage to you mouth but diabetics have a greater risk with smoking. Tobacco generally slows the healing process and causes irritation.
Mouth – Body Connection
Research studies have shown that there is a correlation between periodontal disease and other conditions such as diabetes, heart disease, pregnancy complications and respiratory disease.
Research has shown that individuals with diabetes are more susceptible to periodontal disease. Increased blood sugar can be a benefactor for growing bacteria in the mouth. This creates a perfect atmosphere for periodontal disease to develop as the bacteria have nutrients from the sugar to feed off of.
There are several theories that can explain the link between heart disease and periodontitis. One such theory is that the oral bacteria can travel and attach themselves to the coronary arteries when they enter the bloodstream. This can bring about an increased risk for blood clots. A second possibility is that because periodontal disease causes plaque build up and inflammation, that this can cause the arteries to swell and worsen a heart condition.
Hormone fluctuations that occur during pregnancy cause a risk for women to develop periodontal disease. These hormone fluctuations may also be prevalent in puberty and menopause. Periodontal disease increases the body’s levels of prostaglandin, a labor-inducing chemical. Elevations of this chemical can result in premature labor and the delivery of an underweight baby.
Oral bacteria have been shown to possibly cause or worsen respiratory conditions such as emphysema, pneumonia and Chronic Obstructive Pulmonary Disease (COPD). If oral bacteria are drawn into the lower respiratory tract during normal breathing, the bacteria can colonize, causing an infection. In addition, gum inflammation can lead to inflammation in the lining of the lungs, which can intensify pneumonia.
Causes of Periodontal Disease
Gum disease can be influences by a combination of genetic and environmental factors, and in many cases taking preventative measures can significantly lower the possibility of developing periodontitis.
Here are some of the most common causes of gum disease:
- Poor dental hygiene
- Tobacco use
- Genetic predisposition
- Pregnancy and menopause
- Chronic stress and poor diet
- Diabetes and underlying medical issues
- Grinding teeth
If you have any questions about periodontal disease, please call or contact our office.